Medical Payment Compliance For Managed Care

Contract compliance

Payment compliance is a major issue in any industry where electronic payments are accepted, but it’s especially important in the medical field. For this reason, it’s not unusual for medical establishments to outsource their payment compliance services to a company that’s equipped to manage contract compliance (i.e. contracts between patient and physician). Making sure that patients and insurance providers are keeping their ends of any bargain is crucial to revenue recovery, that is of revenue that has been lost due to improper filing or lack of contract compliance.

Payment compliance has largely to do with managed care, by which various organizations collaborate to improve the cost to benefit ratio of medical care. And with managed care review and payment reviews, in which insurance claims are addressed to find out if they’ve been properly figured and distributed. These issues can grow complex, and it’s part of why outsourcing payment compliance can be such a smart idea. So if you work for a health organization or provider who’s responsible, however indirectly, for assuring payment compliance, then you may want to consider outsourcing this often difficult task to a reliable payment compliance firm.

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